Are US circumcision rates on the rise or decline?

Despite clear health advantages, the rate of neonatal circumcision in the United States has fallen slightly over the past 50 years from a high of 83% in the 1960s to 77% in 2010, according to a recent report.

The researchers say the decline in the neonatal procedure corresponds with the influx of Hispanic immigrants, who traditionally do not circumcise their infants, to the United States and Medicaid no longer paying for the procedure in 18 states.

Morris and colleagues conducted the latest research in response to a 2013 report from the Centers for Disease Control and Prevention (CDC) that claims the opposite. Using National Health and Nutrition Examination Survey data from 2005 to 2010, that study found that the prevalence of circumcision among US men and boys aged 14 to 59 years actually rose slightly over the last decade from 79% to 81%, with white men most likely to be circumcised (91%), followed by blacks (76%), and Hispanics (44%).

However, the investigators of the present study say that because the CDC’s study population was older and most circumcisions in this country are performed during infancy, the CDC study could reflect circumcision rates from up to decades ago rather than current trends.

In addition, Morris and colleagues calculate that the benefits of circumcision exceed the risks by a ratio of 100 to 1. They report that half of all uncircumcised males will require treatment at some point in their lives for a medical condition associated with retention of the foreskin.

The American Academy of Pediatrics’ Circumcision Policy Statement of 2012 agrees that the health benefits-namely prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV-of newborn male circumcision outweigh the risks, and that the benefits “justify access to this procedure for families choosing it.” 

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics eConsult.